Whooping cough is a bacterial infection of the upper respiratory tract involving the nose and the throat, resulting in a cough. Initially, the cough is slow and then, as the cough intensifies, the person coughs in spells or spasms. The person coughs continuously for a few seconds – in which, the person doesn’t breathe — and at the end of the cough, the person takes a deep breath that sounds like a whoop. It is named after the sound the person makes after the cough, because the person inhales and makes a whooping noise. It is also a highly contagious infection that is easily preventable.
What are the causes?
As mentioned earlier, whooping cough – also known as pertussis – is a bacterial infection caused by bordetella pertussis that affects the upper respiratory tract, especially the nose and the throat. It is gotten through droplet infection. For instance, if somebody is infected and the person is coughing, the person throws out drops of secretions like saliva which contains the bacteria and this saliva is thrown into the air and it becomes airborne. Anyone, who inhales the droplets of the secretions through the nose, the bacteria settles there and over a couple of days, it develops to whooping cough.
What are the symptoms of whooping cough?
Initially, the symptoms of whooping cough are just like the symptoms of ordinary cough. The person has a cough, runny nose, catarrh, stuffy nose and low grade fever. Then, gradually, as the infection establishes, the person starts coughing in spasms i.e. coughing continuously without breathing because it does not provide room for the person to breathe. If afterwards, the person takes a deep breath in the sound of a whoop, that is a symptom. However, it is not everyone that has the continuous cough that has whooping cough. In adults, sometimes, they don’t get to that point of coughing in spasms which ends up in a whoop.
In children, especially infants, they might not cough in spasms and give that ‘whoop’ but at the end – due to the fact they have not taken a breath – their face might turn blue or red and they may even cease breathing. This is why it is dangerous in infants because it can kill them. If they experience a cessation of breathing, which is called apnoea, and there is nobody to resuscitate the child or give the child oxygen, the child might give up.
How is it diagnosed?
The diagnosis of whooping cough is by the symptoms. If the patient coughs and it ends in a ‘whoop’, it tells the doctor that the patient may have whooping cough. Otherwise, it can be diagnosed through nasal swab, throat swab and also a blood test and X-ray can be done. When the nasal swab and the throat swab are cultured, the bordetella pertussis will be seen and the doctor will know that the patient has whooping cough. The diagnosis is by microbiological methods and also, when a full blood count is done, the white blood cell will be high, showing that there is an evidence of infection but it’s non-specific. Also, when an X-ray is done – if the whooping cough has become severe to the point of pneumonia – the X-ray will show signs of pneumonia.
How can whooping cough spread?
It spreads easily through airborne respiratory droplets. It can spread by saliva contact like kissing and shared drinks. It can also spread through skin to skin contact like handshakes and hugs due to closeness of the infected person to the uninfected person.
Whooping cough may not necessarily signify that there is something worse going on in the body because it’s a simple upper respiratory tract infection and when a person has whooping cough, it means that the person has contracted a tract infection, especially the upper respiratory tract. It’s not a lower respiratory tract infection as lower respiratory tract can lead to pneumonia. Now, it does not signify any other thing but if it is not treated, it can lead to complications and those complications can now signify that there are other things involved other than the cough.
What are the ways of treating it?
The treatment options are supportive and curative. Supportive is like this: If the nose is blocked, the person is running temperature and is not comfortable, the person is given some painkillers and these tend to relieve the nasal obstruction. Also, if the right antibiotics are given, it will kill the bordetella pertussis and the person is healed.
Is there a difference in treating whooping cough in adults and children?
The treatments are virtually the same. However, in children, and especially, in infants, you pay more attention because, they might get complications.
For instance, if infants get whooping cough, it might cause apnoea which, if severe, can lead to the death of the infant. Also, in children, because their immune system is weak, they can easily develop infections like pneumonia and even brain damage sometimes, if the cough is persistent and it is not relieved quickly and the child is not taking in oxygen, the brain might be affected by poor oxygen concentration. In children, you support them with a lot of fluids because when they are coughing and coughing, their mouth is dry and they might even throw up because of continuous coughing.
They need to be given fluids to rehydrate them. In adults, they don’t really get to that point. They can always take fluids but in children, one needs to pay attention because dehydration can create other complications in children and infants.
What complications can arise if a pregnant woman has whooping cough?
It’s just like an adult having whooping cough except for the fact that the woman is pregnant. The most important thing is to diagnose it early enough and use the appropriate antibiotics that can be given to a pregnant woman. Treatment should not be delayed so that it doesn’t get too severe to the point that it affects the foetus. Early presentation, prompt diagnosis and proper treatment should be applied.
Yes, this is very important. Bordetella pertussis can be prevented through vaccination with a vaccine called DPT. DPT means diphtheria, pertussis and tetanus. It is a combination of three. There is also one called pentavalent vaccine that contains five vaccines and pertussis is one of them. In children, you immunise them at six weeks, 10 weeks and 14 weeks and this protects them. Adults can also be immunised and also pregnant women if there is a need for that. It is preventable and this is why children shouldn’t have it. If the child is immunised, the child will hardly get it. In fact, most children are immunised and that’s why they don’t get it but around the age of 11, the immunity wears off and that’s why some adults or immune-compromised people might get whooping cough. However, it won’t be as severe as somebody who was not immunised at all.
What ages are more prone to whooping cough?
Anybody can get whooping cough but the age bracket, where it is more prevalent, is in children and infants, up to young adults around the ages of 24 and 25. Older adults and elderly people can also get it but it is more prevalent in the younger ones.
What are the myths and misconceptions about whooping cough?
In the olden days, when a person had whooping cough, most people would label it as tuberculosis, which was stigmatised in many villages, depending on where the person came from. They viewed it as a dangerous cough. When a person with whooping cough is taken to the hospital for the doctor to examine the patient and makes diagnosis, it can be cured.
Health facts about whooping cough
The disease is most dangerous to infants and young children. 80 per cent of infants contract pertussis from household members.
Infants are not fully protected from this disease until they receive the fourth dose of DTaP vaccination at 15-18 months of age. Antibiotics may not lessen the symptoms of this disease. Immunity provided by the pertussis vaccine can wane over time. Unvaccinated children are at eight times higher risk of getting pertussis compared to vaccinated children. Preteens and teens (ages 11 to 18) need a booster.
Grandparents and other people over the age of 65 can and should get the Tdap booster. Persons with pertussis are most infectious during the early stages of the disease, including the first two weeks of cough and need to be treated with antibiotics and excluded from work, school, and other group activities to prevent the spread of infection.